IRONBARK RACEWAY EASTER IN THE COUNTRY 2009

PRENOMINATION ENTRIES CLOSE 9PM MONDAY 6TH APRIL 2009

PRENOMINATIONS RECEIVE 2x FREE ENTRY PASSES

Times: Gates: 12.00am Saturday Qualifying: 2.00pm till 9.00pm Racing: 8.00am Sunday

RACE CLASSES

JUNIOR DRAGSTER ------JD

ALL BIKES ------B

STREET 8.50(1/8TH MILE) OR SLOWER------ST

SUPER SUDAN 8.499 (1/8TH MILE) QUICKER------SS

MODIFIED------M

NAME OF DRIVER/ RIDER EVENT DATE 11TH & 12TH April 2009

FIRST NAME______SURNAME ______

ADDRESS ______

SUBURB/TOWN______POST CODE______PHONE NO.______

VEHICLE YEAR______MAKE______MODEL______

ENGINE CYLINDERS ______MAKE______CAPACITY______

E-MAIL ADDRESS______¨Please tick this box if you do not want to receive regular email updates

SPONSORS______

EXCLUSION OF LIABILITY, RELEASE AND ASSUMPTION OF RISK – ENTRANTS/DRIVERS/RIDERS

I/We being the entrant/s and/or driver and/or rider, certify that the particulars on the Entry Form are true and correct in every particular, to the best of my/our knowledge and belief. 1/We declare that I/We have read and understood the Supplementary Regulations issued for the event, and agree to be bound by them and the provisions of the Competition Rules of the Australian National Drag Racing Association Inc. (ANDRA).In Exchange for being able to enter, attend or participate in the event I/WE agree:. to release ANDRA,SWDRA, promoters, sponsors organisations, land owners and lessees, organisers of the event, their respective servants, officials ,representatives and agents (collectively, the “Associated Entities”) from all liability for my death, personal injury (including burns), psychological trauma, loss or damage (including property damage) (“harm”) howsoever arising from my participation in or attendance at the event, except to the extent prohibited by law; that ANDRA and the Associated Entities do not make any warranty, implied and express, that the event services will be provided with due care and skill or that any materials provided in connection with the services will be fit for the purpose for which they are supplied; and to attend or participate in the event at my/our own risk. I/We acknowledge that: the risks associated with attending or participating in the event include the risk that I may suffer harm as a result of motor vehicles (or parts of them) colliding with other motor vehicles, persons or property; acts of violence and other harmful acts (whether intentional or inadvertent) committed by persons attending or participating in the event; and the failure or unsuitability of facilities (including grand-stands, fences and guard rails) to ensure the safety of persons or property at the event. Motor sport is dangerous and that accidents causing harm can and do happen and may happen to me/us. I/We accept the conditions of, and acknowledge the risks arising from, attending or participating in the event and being provided with the event services by ANDRA and the Associated Entities.

NAME OF DRIVER/RIDER______SIGNATURE______/___/_____

NAME OF ENTRANT ______SIGNATURE______/___/_____

Where the Driver/Rider is under the age of 18 years the following Parent/Guardian Consent must be completed:

PARENT/GUARDIAN CONSENT – PERSONS UNDER 18 YEARS OLD

I ______(please print) of (address) ______am the

Parent/guardian* of the above-named (“the minor”) who is under 18 years old. I have read this document and understand its contents, including the exclusion of liability and assumption of risk, and have explained the contents to the minor. I consent to the minor attending/participation in the event at his/her own risk.

Parent/Guardian signature ______Date _____/_____/_____ *delete whichever does not apply

ENTRY FEE $80.00: Admits driver only $______

EXTRA PASSES @ $15.00 (CHILDREN 13 & UNDER FREE) $______

TOTAL $ ______

PAYMENT OPTIONS PLEASE TICK

CHEQUES MUST BE PAYABLE TO SWDRA, Box 1034, Roma, QLD, 4455

or

DIRECT DEPOSIT BANK DETAILS

CBA

BSB : 064428

A/C NUMBER :10067774

PLEASE FAX COMPLETED FORMS TO (07)4622 4884

Competitor Declaration

NOTE: Qualifying or Racing format may be altered or varied at any time by race organisers.

Electronics permitted

Vehicle and Safety Requirements

Purpose built race vehicles and cars quicker than 10.99 must comply with the relevant ANDRA Class and Safety

regulations pertaining to the vehicle. All entrants must be fully licensed for the vehicle and vehicles must have a current technical Inspection.

Other entrant requirements:

Licence. Divisional ANDRA Day Licence will be issued to those who do not need to hold a permanent

ANDRA Drag Race Licence. You must hold a current civil drivers licence.

Protective Clothing. Helmets. All vehicles SLOWER than 10.99 seconds (1/4 mile) helmet to AS1698, 1974/1998

Standard.

Long sleeved upper garment.

Long pants.

Covered shoes.

Your Vehicle Ensure all fluids can be contained within the vehicle.

Tail shaft loops required for cars running QUICKER than 12.99 seconds (1/4 mile).

Minimum 3 point lap sash for cars SLOWER than 11.99 seconds (1/4 mile).

Minimum 4 point harness for cars QUICKER than 11.99 (1/4 mile).

Roll bars are required for open cars 11.00-12.99 (1/4 mile). Open cars quicker than 11.00 must

have full roll cage relevant to ANDRA specifications.

Competitor Declaration

I ______(please print)

Of ______

______

hereby state that:

I or my agent have inspected the vehicle against all items and confirm that the entered vehicle complies with all relevant minimum Safety and Class Eligibility requirements as detailed in the ANDRA Rulebook. The vehicle will be made available for Compliance Audits as requested by the appointed Officials.